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How is that the insurance companies are allowed to "bully" patients . . . I have been fighting stage 4 colon cancer without a break since May 2010 and without exagerration I would estimate that 50% of my surgeries, treatments and/or medications are initially met by denial from Blue Cross Blue Shield of NJ. My current bout includes denial of CyberKnife for treatment of tumor on my spine . . . denial reason was that CyberKnife "does not provide any medical advantage of traditional radiation therapy". HOWEVER, CyberKnife can treat the diseased bone in my spine without contact to my spinal chord . . . Cyber Knife advantage # 1 = reduced risk of complications including paralysis. Cyberknife advantage # 2 - traditional therapy to the affected areas at this point would render any future radiation treatment to that area impossible as I will have had maximum allowed radiation exposure to the spinal chord.
OK so I'm not a Doctor but WOW, this seems pretty straight forward . . . traditional radiation increases risk of paralysis and renders possiblity of future treatment to that area impossible . . . Is it me or does that sound like a pretty distinct advatage.

Oh No (Cancer has spread/Metastasized): Layoff from treatment to allow my body to recover from toxemia allowed cancer to recurr and spread. Recurrances happened in my liver, lymphnodes, and pelvis. Cancer spread to additional areas of spine and into my scapula

Decision Point (Other- assesing and accessing treatment priorities): Serious pain in scapula pointed toward radiation . . . spinal pain could be treated with CyberKnife but insurance company denied CyberKnife saying that it does not provide any medical advantage over traditional radiation therapy BUT advantage 1 is that Cyberknife can target radiation so that it does not hit my spinal chord thus drastically reducing the risk of short or long term paralysis and advantage # 2 is that if I do traditional radiation first it will hit my spinal chord and will rendering it impossible to doANY future radiation to that area.
I am appealing their decision which takes time and time has become a precious commodity until I get necessary treatment.
Please note that nearly every step of the treatment process has been met with denials and roadblocks from Horizon Blue Cross & Blue Shield of NJ. Beware and be aware . . . you will have to advocate for yourself because as unconscionable as it is, at least in my case denial first has been regular operating proceedure

Procedure or Surgery (Liver resection & hepattic pump implant): Resection was to oblate metetastic tumors on my liver . . . they also implanted a hepatic pump to feed chemo directly into liver rather than systemic treatment. Surgery and recovery was extremely painful and rough. I developed toxemia from chemo through hepatic pump so the whole procedure did not help me to get rid of of neutralize liver cancer actitvity

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